HomeMy Public PortalAbout5120TEMPLE CITY BLVD_Mechanical TB A364 - CE ale - RTI PLICA ION PERMIT
HEATIN - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ALITY
REST
FOR APPLICANT TO FILL IN ER(PRINT OR TYPE ONLY) L �I�O No TYPE OF APPLIANCEOR EQUIPMENT FEE RESS /
CITYEL NO
ABSORPTION UNIT, BTU
CONTRACTOR
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BOILER, BTU 33�- '^
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COMPRESSOR BTU LIC
LICENSE NO oSTATE ���7 N CLASS
VENTILATION SYSTEM DISRICT NO GROUP ZONE cEGGED BY
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FURNACE FAUGRAVITV �J• V
FLOOR BTU INSPECTION RECORD
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HEAT; SUSPEN D U IT
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Plan check fee 25% of aboNe See re,Lr.e
PCH\II I Il;SUINC FF f ? 3 00
IOIAI FEI
PLAN CHECK APPLICANT
NAME
ADDRESS
CITY TEL NO
I HEREBY ACKNOWLEDGE THAT 1 HAVE HEAD THIS APPLICATION
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
WITH ALLORDINANCES AND LAWS REGULATING HEATING VENT[- APPROVALS DATE 116 TORS SIGNATURE
LATING AIR COND ITIONINO
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I XEREBY CERTI1O TXAT AM NOT ACTING IN VIOLATION ROUGH A/
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8 OIVISION 3 OF HE BUSINESS AND PROFESSIONAL FINAL �Z
CODE OF THE STATE OF THAT
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15 '24
SIGNATURE PERMIT VA D TION cK M D AsH
OF PERMITTEE
PLAN CHECK VALIDATION CX O CASH
4('- 2 2 1 9-3 JUL 4 1 D 8.00e v
SEE IMCK OF ARM KATIOS FOR COMPLETE FEE SCHEDULE -